产后抑郁症患者大脑自发活动异常的静息态低频振幅fMRI研究

Study on the Resting Low Frequency Amplitude fMRI of Abnormal Spontaneous Brain Activity in Patients with Postpartum Depression

目的利用基于体素的低频振幅(Amplitude of Low Frequency Fluctuation,ALFF)方法探讨产后抑郁症(Postpartum Depression,PPD)患者静息状态下局部神经元自发神经活动异常。方法收集35例PPD患者(PPD组)和34例健康产妇(对照组)的静息态的功能磁共振成像数据,采用独立样本t检验对两组间ALFF值进行比较,并将差异脑区ALFF值与爱丁堡产后抑郁量表(Edinburgh Postpartum Depression Scale,EPDS)得分进行相关性分析。利用观测者操作特性曲线(Receiver Operating Characteristic,ROC)分析判断两组之间差异脑区是否具有诊断价值。结果与对照组相比较,PPD组的前扣带回、楔前叶ALFF值减低,岛叶、颞上回ALFF值增高,但这些异常脑区的ALFF值与患者EPDS得分无相关性。ROC曲线结果显示,差异脑区的曲线下面积均超过0.83。结论PPD患者默认网络、突显网络和中央执行网络相关脑区功能存在异常改变,具有一定的诊断准确性,这为了解产后抑郁患者的发病机制提供了影像学参考。

Objective To explore abnormal spontaneous neuronal activity in patients with postpartum depression(PPD)under amplitude of low frequency fluctuation(ALFF).Methods Resting-state functional MRI data of 35 PPD patients(PPD group)and 34 healthy postpartum women(HPW group)were collected,the differences in ALFF values between the two groups were compared by the independent sample t test,and the correlation between the Edinburgh Postnatal Depression score(EPDS)and the abnormal mean ALFF values of the brain regions in PPD patients was analyzed.The receiver operating characteristic(ROC)curve analysis was used to judge the diagnosis value of the brain regions with abnormal ALFF.Results Compared with the control group,PPD group showed decreased ALFF values in the anterior cingulate,posterior cingulate cortex.PPD group had increased ALFF values in the insula,superior temporal cortex,there was no correlation between their ALFF values and EPDS.The area under the ROC curve of each brain area with abnormal ALFF in PPD was above 0.83.Conclusion There are abnormal changes in the functions of brain regions related to default network,salience network and central executive network in patients with PPD.The brain areas with abnormal ALFF have appropriate diagnosis values,which provides imaging references for understanding the pathogenesis of PPD.